The oncoming nurse receives report on a group of clients. Which client should have priority during the nurse’s rounds?

  • a client who just returned from surgery for an open appendectomy
  • a client with a blood pressure of 184/86 who has not received the morning dose of lisinopril
  • a client who is on a 100% non-rebreather mask with an oxygen saturation level of 96%
  • a client with COPD who is on 2L of oxygen via nasal cannula with an oxygen saturation level of 90%
Number 1 is correct.
The client returning from surgery is the priority here, especially since an open appendectomy was performed. A client with an open procedure is at greater risk of bleeding than clients who have laparoscopic surgeries. The nurse should view the dressing and verify that it is dry and intact, or note and mark any staining. The client due for lisinopril would be expected to have a higher blood pressure; the nurse can assess the client and then administer the medication early if needed. The client on the non-rebreather mask has an expected oxygen saturation level of 96%, which is in the acceptable range. The client with COPD tends to have lower oxygen saturation levels, even on oxygen. Too much oxygen can compromise breathing, as the drive to breathe is caused by being slightly hypoxic in COPD clients.